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To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1177/1051228405279988 Byline: Kazuo Abe (1), Tachio Hikita (1), Masaru Yokoe (1), Masahito Mihara (1), Saburo Sakoda (1) Keywords: Multiple system atrophy (MSA); MRI Abstract: ABSTRACT Patients with multiple system atrophy (MSA) may show the 'cross' sign in the pontine base that has been considered as an expression of the degeneration of pontine neurons and transverse pontocerebellar fibers. However, correlations between pontine base atrophy and existence of 'cross' sign have not been fully investigated. The authors studied 68 patients with MSA (47 MSA-C [predominantly cerebellar ataxia], 21 MSA-P [predominantly parkinsonism], mean [[+ or -]SD ] 58.7 [+ or -] 10.9 years). T1-weighted (T1W) sagittal and axial images and T2-weighted (T2W) axial images were obtained for all patients and controls. To measure the areas of pontine basis and cerebellar vermis, the authors used midsagittal T1W images and analyzed a bit map transformed on a computer. They classified atrophy in the pontine base into 3 grades. There is significant correlation between atrophies of pontine base and existence of the cross sign. All patients with a smaller area of pontine base 2 standard deviations below those of normal controls had the cross sign. This supports that existence of the cross sign depends only on the extent of pontine base atrophies. Author Affiliation: (1)From the Department of Neurology, Graduate School of Medicine, Osaka University. Article History: Received October 8, 2004, and in revised form April 4, 2005. Accepted for publication April 8, 2005. Article note: Address correspondence to Dr Kazuo Abe, D-4, Department of Neurology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. E-mail: abe@neurol.med.osaka-u.ac.jp.

The factors predicting the progression of coronavirus disease‐2019 (COVID‐19) from mild to moderate to critical are unclear. We retrospectively evaluated risk factors for disease progression in Japanese patients with COVID‐19. Seventy‐four patients with laboratory‐confirmed COVID‐19 were hospitalized in our hospital between February 20, 2020, and June 10, 2020. We excluded asymptomatic, non‐Japanese, and pediatric patients. We divided patients into the stable group and the progression group (PG; requiring mechanical ventilation). We compared the clinical factors. We established the cutoff values (COVs) for significantly different factors via receiver operating characteristic curve analysis and identified risk factors by univariate regression. We enrolled 57 patients with COVID‐19 (median age 52 years, 56.1% male). The median time from symptom onset to admission was 8 days. Seven patients developed critical disease (PG: 12.2%), two (3.5%) of whom died; 50 had stable disease. Univariate logistic analysis identified an elevated lactate dehydrogenase (LDH) level (COV: 309 U/l), a decreased estimated glomerular filtration rate (eGFR; COV: 68 ml/min), lymphocytopenia (COV: 980/μl), and statin use as significantly associated with disease progression. However, in the Cox proportional hazards analysis, lymphocytopenia at admission was not significant. We identified three candidate risk factors for progression to critical COVID‐19 in adult Japanese patients: statin use, elevated LDH level, and decreased eGFR. Highlights: To evaluate risk factors for disease progression in Japanese patients with COVID‐19, we examined seventy‐four patients with laboratory‐confirmed COVID‐19.Seven patients (12.2%) developed critical disease requiring mechanical ventilation, two (3.5%) of whom died.We identified three candidate risk factors for progression to critical COVID‐19 in adult Japanese patients: statin use elevated LDH level and decreased eGFR. [ABSTRACT FROM AUTHOR]

This study investigated the risk factors for fractures in patients with Parkinson's disease (PD). A questionnaire specifically designed to examine these risk factors was mailed to 172 PD patients registered in our self-developed PD database. We subsequently received replies from 158 patients, 22(14.8%)of whom had experienced fractures after PD onset. A multiple logistic regression model was used to evaluate the responses, and together with the clinical information stored in our PD database, it was revealed that psychiatric symptoms and falls within 1 year of our investigation were statistically correlated with the occurrence of fractures (adjusted odds ratio: 4.8 and 3.6, respectively). Thus, these results emphasize that psychiatric symptoms are an essential risk factor for fracture in PD patients.

Objective: To assess the pain-relieving effects of motor cortex electrical stimulation (MCS) and the predictive factors retrospectively., Methods: Thirty-four patients with intractable neuropathic pain underwent MCS; 19 patients had cerebral lesions, and 15 had non-cerebral lesions. In selected 12 patients, test electrodes were implanted within the central sulcus and on the precentral gyrus. Twelve patients received both MCS and repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex., Results: Pain reduction of >50% was observed in 12 of 32 (36%) patients with >12 months follow-ups (2 patients were excluded because of short follow-up). In 10 of the 12 patients who received test electrodes within the central sulcus and on the precentral gyrus, the optimal stimulation was MCS within the central sulcus. In 4 of these (40%) patients, positive effects were maintained at follow-ups. The pain reduction of rTMS significantly correlated with that of MCS during test stimulation., Conclusions: The test stimulation within the central sulcus was more effective than that of the precentral gyrus. In the selected patients, chronic stimulation within the central sulcus did not significantly improve long-term results. Repeated rTMS seems to be same effective as MCS.

We propose a linear discriminant regression analysis (LDRA) that provides an estimated severity marker for discriminating between healthy and patient groups and estimating severities of the patient group simultaneously. This method combines an evaluation function for discriminating between two groups and one for estimating severities of one group. The combined function is optimized to obtain an equation for calculating estimated severities. The method was evaluated with finger-tapping data of healthy and Parkinson's disease (PD) groups and PD severities assessed by a doctor. As a result, the discrimination ability of LDRA (AUC: 0.8835) was higher than that of discriminant analysis (DA. AUC: 0.8442), which is a conventional method for classification, and the regression ability of LDRA (mean square error (MSE): 1.27) was superior to that of multiple regression analysis (MRA. MSE: 1.68), which is a conventional method for regression. The results show that LDRA is an effective method for estimating the presence and severity of Parkinson's disease.

This paper proposes a method of estimating fingertip forces in finger tapping movements based on human fingerpad characteristics. Since the human fingerpad exhibits elasticity, the proposed technique recreates the relationship between the fingertip force and the displacement generated between the thumb and index fingerpads as a fingerpad-stiffness model. Then, using this model, the force between the two fingertips (the fingertip force) can be estimated from the measured fingerpad deformation only. As the method does not require any sensors to be attached to the finger contact surface to measure fingertip force, it can be used to evaluate the tendency of force in natural and unconstrained finger tapping movements conducted by the subject. In the experiments conducted, fingertip forces and the displacement of the two fingerpads generated when the subjects pinched and pushed a force sensor with the thumb and index finger were measured to approximate the relationships between fingerpad force and deformation. The results indicated that human fingerpad characteristics can be expressed using a fingerpad-stiffness function (including an exponential function), and that fingerpad forces can be estimated using the proposed model. Furthermore, comparison between a Parkinson's disease (PD) patient and a healthy subject confirmed differences in the finger tapping forces for each. This implies the possibility of assessing motor function in PD patients using the finger tapping force evaluation method proposed in this paper.

Spatial temporal plantar pressure patterns measured with sheet-shaped pressure sensor were investigated to extract features of gait in Parkinson's disease. Both six subjects of Parkinson's disease (PD) and elderly fourteen normal control subjects were asked to execute usual walking on the pressure sensor sheets. Candidate features were step length, step time, gait velocity and transition of center of pressure to foot axis direction. The step length and gait velocity were smaller in PD subjects than those in normal subjects. Time of step cycle in three PD subjects were longer than that in normal subjects while the times of other PD subjects were similar to those of control subjects. The length from heel contact to toe off within one footprint was small in the subjects with short step length. Such possibility was indicated that Parkinson's disease in gait could be separated from normal subjects by these features.